title: Tumour necrosis factor-α antagonists in patients with concurrent psoriasis and hepatitis B or hepatitis C: a retrospective analysis of 17 patients.
abstract: BACKGROUND
  Tumour necrosis factor (TNF)-α antagonists are effective for the treatment of plaque-type psoriasis and psoriatic arthritis, but concerns remain about the safety of these agents in the presence of chronic infections, including past hepatitis B (HBV) and chronic hepatitis C virus (HCV) infections.
  
  
  OBJECTIVE
  To assess the safety of TNF-α therapy in patients with plaque-type psoriasis and concurrent past HBV or chronic HCV.
  
  
  METHODS
  Data were collected retrospectively from patients in the PsoCare Centre, Division of Dermatology II, Florence University. Patients with plaque-type psoriasis who were receiving anti-TNF-α therapy were retrospectively reviewed for the presence of HBV or HCV by a serological evaluation.
  
  
  RESULTS
  Seventeen patients (13 men and four women, age 36-74 years) with plaque-type psoriasis associated with hepatitis infections (11 with past HBV infection, five with chronic HCV infection and one affected by both HBV and HCV) were identified. Fourteen patients had received etanercept, two adalimumab and one adalimumab as a second biologic treatment after an unsuccessful trial of etanercept. In none of the cases were changes in serum aminotransferases or viral load reported.
  
  
  CONCLUSIONS
  In our analysis, the use of anti-TNF-α therapy appears to be safe as it did not affect serum aminotransferases or viral load. However, repeated monitoring is necessary throughout the treatment period. Systematic, large-scale studies are also needed to assess the risks and benefits of TNF-α antagonists in these patients.
authors.affiliation: Division of Dermatology II, Department of Critical Care Medicine and Surgery, Florence University, Villa S. Chiara, Italy. francesca.prignano@unifi.it
authors.forename: F
authors.initials: F
authors.lastname: Prignano
authors.forename: F
authors.initials: F
authors.lastname: Ricceri
authors.forename: L
authors.initials: L
authors.lastname: Pescitelli
authors.forename: F
authors.initials: F
authors.lastname: Zanieri
authors.forename: T
authors.initials: T
authors.lastname: Lotti
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068800:Etanercept; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012189:Retrospective Studies; D000637:Transaminases / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D019562:Viral Load
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000637:Transaminases; D000068879:Adalimumab; D000068800:Etanercept